AB0430 MEDICATION ADHERENCE IN PATIENTS AFFECTED BY RHEUMATOID ARTHRITIS TREATED WITH BIOLOGIC OR TARGET SYNTETIC -DMARDS: EVALUATION OF PREDICTIVE FACTORS IN AN ITALIAN MONOCENTRIC COHORT
Authors: L. Moschetti, C. Bazzani, F. Delvecchio, F. Franceschini
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> In rheumatoid arthritis(RA), medication non-adherence can be considered one of the primary determinants of therapeutic failure. <h3>Objectives</h3> To evaluate 1)the prevalence of treatment adherence in RA patients(pts) treated with biologic(b) or target synthetic(ts)-DMARDs followed in a tertiary rheumatologic center and 2)the factors associated to a better treatment adherence. <h3>Methods</h3> An observational retrospective single center study was conducted enrolling adult RA pts treated with b/ts-DMARDs, in monotherapy or in combination with methotrexate. Demographic data, clinical characteristics and outcomes measures were collected. To evaluate the comorbidities the Rheumatic Disease Comorbidity Index(RDCI) was used. Treatment adherence was assessed through self-reported adherence rate(SRAR) rated on a visual analogue scale (VAS, 0-100 mm) and 5-item Compliance Questionnaire for Rheumatology(CQR5). Pts were considered adherent if SRAR ≥80/100. All the participants were required to complete: VAS pain questionnaire, Patient Global Assessment(PGA), Health Assessment Questionnaire(HAQ), Depression Anxiety Stress Scales(DASS21), Insomnia Severity Index and self-reported VAS therapy satisfaction scale (0-100 mm, higher values indicate higher satisfaction). <h3>Results</h3> Among the 116 pts (Table 1) evaluated, 57% described themselves as being adherent to their treatment (median SRAR: 80 [60-90]; median satisfaction level: 80 [60-90]). According to CQR5, 97% of the pts presented a high adherence level; 28/116 pts declared a treatment suspension during the previous month; in most cases the withdrawal was reasonable (due to vaccinations, infections, surgery). The comparison between adherent and non-adherent pts is shown in Table 1: a significative association between non-adherence and higher DAS28, HAQ and VAS pain scores was observed; in addition, an association was found between adherence and treatment satisfaction level. No significant differences in demographic features, educational level, work status, comorbidities and therapeutic formulation/plan/type were found. Patient's reported outcomes scores regarding insomnia/anxiety/depression/stress were higher in non-adherent pts but not statistically different. <h3>Conclusion</h3> Treatment adherence is still a complex process difficult to measure. Our data show a discrepancy between SRAR and CQR5 adherence assessment (57% vs 97%). In our cohort of pts, regularly followed-up in a tertiary outpatient clinic, the prevalence of adherence is overall higher as compared with that reported in literature (medication adherence in RA pts: 30-80%)<sup>[1]</sup>. In this study, treatment adherence seems to be associated with a higher therapy satisfaction level and a lower disease activity, pain perception, and physical disability. However, a cause-effect relationship still remains difficult to analyze. <h3>Reference</h3> [1] Van den Bemt BJF et al. Expert Rev Clin Immunol. 2012. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> None Declared.